Postpartum depression (PPD) can be differentiated from the baby blues by timing, duration, and/or severity.1-7
Understanding the key differences
The baby blues generally peaks within the first few days postdelivery and resolves without treatment within 2 weeks.3,7
Expert opinions vary as to the timing of the onset of PPD. For example, symptoms of PPD can begin:
- During pregnancy or following childbirth up to 4 weeks (DSM-5 definition)2
- During pregnancy or following childbirth up to 12 months (ACOG definition)8
Without treatment, symptoms may persist for months or up to a year.9
Estimated to affect up to 80% of women after childbirth.3,10
In the US, estimates of new mothers identified with PPD each year vary by state from 8% to 20%, with an overall average of 11.5%.11
While symptoms of the baby blues can overlap with those of PPD, they typically3,10,12:
- Are generally less severe
- Are shorter in duration
- Do not interfere with daily activities
- Do not impair maternal function
- Frequent crying
- Mood swings
- Feeling sad, hopeless, empty, or overwhelmed
- Crying more often than usual or for no apparent reason
- Worrying or feeling overly anxious
- Insomnia or hypersomnia
- Physical aches and pains
- Changes in appetite
- Feeling moody, irritable, or restless
- Experiencing anger or rage
- Trouble concentrating
- Losing interest in activities that are usually enjoyable
- Withdrawing from friends and family
- Trouble bonding with her baby
- Persistently doubting her ability to care for her baby
- Thoughts of harming herself or her baby
- Anxiety in the form of intrusive or obsessive thoughts about the baby
- Frequently Asked Questions: Postpartum Depression. American College of Obstetricians and Gynecologists website. https://www.acog.org/-/media/For-Patients/faq091.pdf?dmc=1&ts=20180524T2244520338. Accessed May 24, 2018.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association Publishing; 2013.
- Earls MF; Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.
- Prevalence of Self-Reported Postpartum Depressive Symptoms—17 States, 2004-2005. Centers for Disease Control and Prevention website. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5714a1.htm. Accessed November 2, 2017.
- Robertson E, Celasun N, Stewart DE. Risk factors for postpartum depression. In: Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T. Postpartum Depression: Literature Review of Risk Factors and Interventions. Toronto, Canada: University Health Network Women’s Health Program; 2003.
- Depression Among Women. Centers for Disease Control and Prevention website. https://www.cdc.gov/reproductivehealth/depression/index.htm. Accessed May 3, 2018.
- Postpartum Depression Facts. National Institute of Mental Health website. https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml. Accessed November 20, 2018.
- American College of Obstetricians and Gynecologists. Committee opinion: screening for perinatal depression. Obstet Gynecol. 2018:757.
- Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry. 2014;22(1):1-22.
- Moses-Kolko EL, Roth EK. Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Womens Assoc. 2004;59(3):181-191.
- Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL. Trends in postpartum depressive symptoms—27 states, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep. 2017;66(6):153-158.
- As reviewed in Thurgood S, Avery DM, Williamson L. Postpartum depression (PPD). Am J Clin Med. 2009;6(2):17-22.
- Abramowitz JS, Meltzer-Brody S, Leserman J, et al. Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Arch Womens Ment Health. 2010;13(6):523-530.